Biogas nutrient management in organic cropping - not only a nitrogen issue

Nutrient imbalance, mainly due to low K and high Ca and/or Mg concentrations, was a plausible explanation for low growth response to digestate fertilisation by beetroot following harvested grass-clover biogas ley. To derive the full benefit of a transition to a biogas nutrient management (BG) system, extra nutrients except for N may need to be added, especially if digestate supply is divided between many crop positions in the rotation. This is probably of extra importance on sandy soils such as that used in this experiment

Organic production systems in Northern highbush blueberries

The production of highbush blueberries is increasing worldwide. Organic production of blueberries in Sweden is presently very limited but is expected to have a great potential to expand as the berries are popular and have a good shelf life. The fact that blueberries require acid soils raises several questions concerning suitable substrates in combination with mycorrhizal inoculation and fertilization in organic production systems. Field and pot experiments have been established during 2011 and 2012 with the aim of developing a sustainable production system for high quality organic blueberries. After the second experimental year, total fruit yields were similar for plants grown in a plastic tunnel and in the open field. Yields were not affected by the addition of 10% forest soil to the peat-based substrate. Inoculation with ericoid mycorrhizal fungi had little effect on shoot length in a greenhouse pot experiment. Blueberries may be particularly suitable for organic production as the need for fertilizers is low combined with a relatively low disease pressure on the blueberry crop in the Nordic countries. The Swedish blueberry production might be expected to expand in the near future. The development of a successful and resource-efficient growing system for organic blueberries may encourage new blueberry growers to chose organic production

К 75-летию профессора О. П. Чудакова

стоматологипреподавателиИСТОРИЯ МЕДИЦИНЫврач

Evaluation of whole-body bone scans performed using a gamma camera with Cadmium Zinc Telluride detector

The bone scan is a common nuclear medicine imaging procedure that is mainly used for evaluating several oncological patient groups. A radioactive tracer, 99mTc -labelled diphosphonate, is injected intravenously and accumulates in the skeleton. The distribution of the tracer in the body is measured with a gamma camera 3 hours post-injection. Conventional gamma cameras used in nuclear medicine are based on scintillation detectors made of thallium-doped sodium iodine (NaI(Tl)). During recent years, progress has been made regarding the production of direct conversion room temperature semiconductor-detectors. One such detector is made of cadmium zinc telluride (CZT), and in comparison to NaI(Tl), CZT has better energy resolution. In the spring of 2020, a NM/CT 870 CZT gamma camera manufactured by GE Healthcare was installed at Sahlgrenska university hospital. The primary aim of this study was to evaluate planar whole-body bone scans on a NM/CT 870 CZT gamma camera by comparing the image quality with a conventional gamma camera. Additional aims were to, for the NM/CT 870 CZT gamma camera, evaluate the effect that reduced scan time/activity level and the use of the post-processing Clarity 2D has on the image quality and to determine the effect that different Clarity 2D blending has on the spatial resolution. Two different patient groups were used for the retrospective visual grading study. The first group consisted of 16 patients with advanced disease who had been scanned on both the NM/CT 870 CZT and a conventional gamma camera at separate occasions. The second group consisted of 32 patients who underwent their first bone scan, where 16 patients were scanned on the NM/CT 870 CZT, while the other 16 were scanned on a conventional gamma camera. For all examinations, the administered activity and scan time were approximately the same. For the examinations performed on the NM/CT 870 CZT, the original images were used to simulate 3 different scan times/activity levels (25 %, 50 % and 75 % of the original 100 %). Additionally, 5 different Clarity 2D blendings were used for each level. The evaluation was accomplished by performing a visual grading characteristics (VGC) analysis in a beta-version of the software ViewDEX 3.0, with two physicians participating as observers. Seven image criteria were rated with a five-step ordinal scale, where the observers stated their confidence on the fulfilment of each criterion. The software VGC Analyzer 1.0.2 was used to perform statistical analysis of the observer ratings. The effect of Clarity 2D on the spatial resolution was evaluated using a Triple Line Insert-phantom, model ECT/TRI/I. The images were also evaluated quantitatively, the bone-to-soft tissue relationship was calculated by dividing the average counts in the sinister sacroiliac joint with the standard deviation of counts in adjacent soft tissue The results showed that the original CZT images with no post-processing were graded equal to or significantly higher than the images from the conventional gamma cameras for all image quality criteria in both patient groups. For the CZT images with a simulated scan time/activity level of 75 % of the original settings, no significant differences were found. The CZT images with a simulated scan time/activity level of 50 % of the original settings were graded equal to or significantly lower than the images from the conventional gamma cameras. The CZT images with a simulated scan time/activity level of 25 % were graded significantly lower for IV most of the criteria. This indicated that the scan time/activity level for whole-body bone scans on the NM/CT 870 CZT could be lowered to 75 % of the original setting without decreasing the image quality compared to a conventional gamma camera. The results also showed that the positive effect of Clarity 2D post-processing was more prominent in the simulated images with reduced scan time/activity level. The quantitative measurements showed that the spatial resolution as well as the bone-to-soft tissue relationship improved with increasing Clarity 2D blendings

Advanced Ovarian Cancer. A multimodal diagnostic approach to predict outcome

Primary debulking surgery (PDS) followed by platinum-based postoperative chemotherapy isthe standard of care for advanced ovarian cancer (AOC). Absence of macroscopic residualdisease after debulking surgery is the strongest prognostic factor achieved by surgery. Correctcharacterization of the tumor specimen and tumor spread in combination with patient’scharacteristics such as age, comorbidity, and personal wishes, can help to select more effectivetherapeutic approaches for each patient before initial intervention.The overall aim of this thesis were to evaluate diagnostic, from the preoperative to theintraoperative stage, to investigate how an accurate diagnosis could predict surgical outcomeand survival in patients with advanced ovarian cancer.Study I: A retrospective population-based review was conducted of 328 biopsies, in order toassess the adequacy, accuracy and safety of tru-cut biopsy in gynecological malignancies fromthe perspective of a daily clinical practice. The tru-cut biopsy was shown to be a reliable andsafe diagnostic method, with adequacy of 86.3%, accuracy of 97.5% and a complication rate of1.3%. The adequacy of tru-cut biopsy depends on the site of the tissue sample, indications forthe biopsy and the experience of the operator.Study II: A single-center, retrospective population-based study was conducted on 358 patients,to evaluate the reliability of intraoperative FS diagnosis for planning the treatment of patientswith suspected ovarian cancer (OC), from a multidisciplinary perspective. Prevalence,sensitivity, specificity, positive predictive value and negative predictive value for invasivemalignancies on FS were 54.0%, 88.1%, 98.8%, 98.9% and 87.6% respectively. Malignancywas observed to be underestimated, but overestimation in malignancy grading was rare.Borderline-related tumors were more likely to be incorrectly graded by FS, as were rare tumortypes. Despite diagnostic difficulties, in some of the cases, the oral communication duringdeliverance of frozen section diagnosis resulted in adequate treatment decisions, whichminimalized the risk for reoperation or delay of chemotherapy treatment.Studies III and IV: A single-center, retrospective population-based study was conducted on 118patients with AOC, to determine whether the PCI and the quantity of ascites visualized bycomputed tomography (CT) could assess the extent of the tumor (S-PCI) and residual disease(RD) for AOC patients treated with PDS. Furthermore, in study IV, we examine the impact ofthe tumor extent on survival. CT-PCI correlated well with S-PCI and the risk of RD, with a cutoffof 21 for CT-PCI (0.715, p = 0.000). The risk of RD was 3.5 times higher when the quantityof ascites on CT (CTascites) was estimated to be above 1000ml. Regardless of the completenessof cytoreductive surgery or the complication rate, the extent of the tumor at the beginning ofsurgery seemed to affect OS in patients with AOC. PCI above 18.5 doubled the risk of dyingof the disease. CT-PCI seemed to play a prognostic role for PFS, but its prognostic role for OSis still to be investigated.Conclusions: The existing methods of preoperative material retrieval and histopathologicaldiagnosis of ovarian cancer are reliable, when performed by highly trained specialists. Thepreoperative CT is accessible and can be used by an experienced radiologist as a singletechnique to select patients as candidates for PDS. The complete removal of the tumor is a veryimportant prognostic factor for prognosis in AOC, but patient’s status and tumor biology arealso important factors in the decisionmaking on a treatment plan. This thesis maintain the ideathat centralization of cancer care to tertiary centres results in highly specialized pathology,radiology, oncology and surgical departments, and that the multidisciplinary diagnostic andtherapeutic efforts improve health care, and possibly the outcome, for patients with AOC

Family Based Treatment for Adolescents with Eating Disorders: A Clinician’s Perspective

The purpose of this study was to explore the nuances of Family-Based Treatment (FBT) in a clinical setting, as well as the areas of growth and development within the use and implementation of this treatment modality as it relates to adolescents with eating disorders. Qualitative interviews were conducted with four mental health clinicians who primarily use FBT in their work with adolescents with eating disorders. Through the use of grounded theory methodology, each interview was audio-recorded, transcribed, and coded over the course of a month to produce four main themes. The most common themes within the interview transcripts included: 1) FBT process, 2) FBT supports the family system, 3) FBT commitment, and 4) FBT development. Through the use of these four themes, the current research study further highlighted the importance of incorporating the family system into the recovery process of their adolescent with an eating disorder and revealed the important distinctions that are contained within this treatment modality

Family Based Treatment for Adolescents with Eating Disorders: A Clinician\u27s Perspective

The purpose of this study was to explore the nuances of Family-Based Treatment (FBT) in a clinical setting, as well as the areas of growth and development within the use and implementation of this treatment modality as it relates to adolescents with eating disorders. Qualitative interviews were conducted with four mental health clinicians who primarily use FBT in their work with adolescents with eating disorders. Through the use of grounded theory methodology, each interview was audio-recorded, transcribed, and coded over the course of a month to produce four main themes. The most common themes within the interview transcripts included: 1) FBT process, 2) FBT supports the family system, 3) FBT commitment, and 4) FBT development. Through the use of these four themes, the current research study further highlighted the importance of incorporating the family system into the recovery process of their adolescent with an eating disorder and revealed the important distinctions that are contained within this treatment modality